Please help -- high risk incident and ARS symptoms
Jul 8, 2005
Hi Dr. Frascino. You are my hero! Anyway, 11 weeks ago, I had unprotected (actually the condom broke early on -- I remember it in retrospect, but at the time I didn't think about it and continued having sex for maybe 4-5 minutes) insertive (I am uncircumcized) vaginal sex with someone who I later found out was recently infected with HIV. 25 days later, I got a high fever which kept me in bed all day, and then 2 weeks of extreme fatigue/mono like illness, culminating with a large red patchy rash above my groin, and white patches (candida?) througout my mouth and the sorest throat of my life for a few days. I figured this was ARS, but I don't have insurance and didn't know what to do. I went to do an oral quick test at a free clinic at both 6 weeks and 10 weeks and both came back negative. However, I still have symtoms -- very tired and achy muscles -- overall strenth and endurance maybe one-third of normal. What would you advise me to do?? How likely do I have HIV? What else could cause these symptoms? I have recently learned that it is possible to do a DNA PCR test. Is this advisable? If I do another oral test at 13 weeks, will that definitely rule out HIV? Please help! I am going crazy over the uncertainty!
Response from Dr. Frascino
Your estimated risk for acquisition of HIV from insertive penile-vaginal sex with condom failure is 5 per 10,000 exposures to an HIV-infected partner. Your negative tests at 6 and 10 weeks are very encouraging, but not definitive. I would recommend repeating an HIV test at the three-month mark. If that test is also negative, I would consider your negative status to be definitive.
I can not diagnose the cause of your symptoms over the Internet. If they persist, you'll need to have them evaluated by a physician.
HIV DNA PCR tests are very expensive and most likely not available at the "free clinic." They are also not recommended for routine HIV screening. I use them mainly to diagnose neonatal HIV infection. It can also be useful at times to sort out disputed or indeterminate serological tests, in patients with agammaglobulinemia and, in some cases, to diagnose acute retroviral infection. For your situation, I do not feel an HIV DNA PCR is advisable.
I'll send you my best good-luck karma that your three-month test remains negative.
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